{"id":191,"date":"2024-06-23T21:33:18","date_gmt":"2024-06-23T19:33:18","guid":{"rendered":"https:\/\/grossicardiologo.it\/?p=191"},"modified":"2026-03-09T10:14:40","modified_gmt":"2026-03-09T09:14:40","slug":"trattamenti-occlusione-percutanea-dell-auricola-sinistra","status":"publish","type":"post","link":"https:\/\/grossicardiologo.it\/en\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/","title":{"rendered":"Percutaneous Left Atrial Appendage Occlusion"},"content":{"rendered":"
\n\n
\n

What is the left atrial appendage?<\/h2>\n\n\n\n

The left atrial appendage is an extension of the left atrium, varying in shape and size among individuals, though generally small in dimensions, where blood flows more slowly (Fig. 1).<\/p>\n<\/div><\/div>\n\n\n\n

\n
\"auricola
Fig. 1<\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div>\n\n
\n\n
\n

Why is left atrial appendage closure performed?<\/h2>\n\n\n\n

In cases of atrial fibrillation, the atrial walls lose their ability to contract effectively, causing blood to stagnate, particularly in the appendage. This stagnation can lead to blood clots forming within the appendage, which may subsequently escape into the bloodstream, causing peripheral embolisms, particularly ischemic strokes (Fig. 2).<\/p>\n\n\n\n

20% of all ischemic strokes are caused by atrial fibrillation. <\/strong><\/h3>\n\n\n\n

At-risk patients are usually prescribed anticoagulant medications to mitigate this risk.<\/p>\n\n\n\n

\"occlusione
Fig. 2\nA: Thrombus formation (T) within the left atrial appendage (LAA).\nB, C: Progressive movement of the thrombus out of the appendage toward the left atrium (LA).\nD: The thrombus is no longer visible, having entered the bloodstream, significantly increasing the risk of stroke.<\/figcaption><\/figure>\n\n\n\n

When anticoagulants are contraindicated, poorly tolerated, or ineffective for a patient, an alternative is to close the appendage to prevent blood from circulating within it, thus eliminating the risk of clot formation.<\/p>\n\n\n\n

<\/p>\n\n\n\n

How is left atrial appendage occlusion performed?<\/h2>\n\n\n\n

The procedure is performed percutaneously via the blood vessels in the groin, similar to ablation procedures.\nPatients are generally sedated, and general anesthesia is typically unnecessary.\nOnce the left atrium is accessed, a device is positioned within the appendage to completely occlude its lumen, excluding it from blood circulation (Fig. 3A, 3B).<\/p>\n\n\n

\n\n
\n
\"occlusione
Fig. 3\nA, B: Occlusion of the left atrial appendage using a percutaneous device.\nC: An alternative, more recent method involves external access to the heart cavity (pericardial space) via a puncture below the sternum. The appendage is excluded from circulation using a lasso that externally constricts its neck.<\/figcaption><\/figure>\n<\/div><\/div>\n\n\n\n
\n

In high-volume centers, the procedure has a success rate exceeding 95%,<\/p>\n\n\n\n

with a complication rate below 1%.<\/p>\n\n\n\n

The electrophysiologist selects the technique based on the patient's characteristics.<\/p>\n\n\n\n

Dr. Grossi's Experience<\/p>\n\n\n\n

Dr. Grossi has over 15 years of experience in percutaneous left atrial appendage occlusion and was the first in the world to develop and perform a combined procedure of endo-epicardial atrial fibrillation ablation and left atrial appendage occlusion using the Lariat system.<\/strong> For cases of atrial fibrillation resistant to standard ablation procedures, occlusion of the appendage using the Lariat lasso not only achieves hydraulic closure, eliminating the stroke risk, but also causes atrophy that eliminates its electrical activity, a key factor in maintaining atrial fibrillation.<\/p>\n<\/div><\/div>\n\n<\/div><\/div><\/div><\/div>\n\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

Che cosa \u00e8 l\u2019auricola sinistra? L\u2019auricola sinistra \u00e8 una appendice dell\u2019atrio sinistro di forma e dimensioni diverse tra un soggetto e un altro, che si caratterizza comunque per dimensioni abbastanza ristrette e al cui interno dunque il sangue scorre lentamente (Fig 1). Per quale motivo si esegue la chiusura dell\u2019auricola sinistra? In corso di fibrillazione […]<\/p>\n","protected":false},"author":1,"featured_media":166,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10,9],"tags":[],"class_list":["post-191","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fibrillazione-atriale","category-trattamenti"],"yoast_head":"\nOcclusione percutanea dell\u2019auricola sinistra - Dr. Stefano Grossi<\/title>\n<meta name=\"description\" content=\"L\u2019occlusione percutanea dell'auricola sinistra impedisce al sangue di circolare e quindi coagulare dando adito ad un rischio embolico.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/grossicardiologo.it\/en\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Occlusione percutanea dell\u2019auricola sinistra - Dr. Stefano Grossi\" \/>\n<meta property=\"og:description\" content=\"L\u2019occlusione percutanea dell'auricola sinistra impedisce al sangue di circolare e quindi coagulare dando adito ad un rischio embolico.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/grossicardiologo.it\/en\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/\" \/>\n<meta property=\"og:site_name\" content=\"Dr. Stefano Grossi\" \/>\n<meta property=\"article:published_time\" content=\"2024-06-23T19:33:18+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-03-09T09:14:40+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/2024\/06\/title-trattamenti-fibrillazione-atriale.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1002\" \/>\n\t<meta property=\"og:image:height\" content=\"202\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Giovanna\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Giovanna\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/grossicardiologo.it\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/grossicardiologo.it\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/\"},\"author\":{\"name\":\"Giovanna\",\"@id\":\"https:\/\/grossicardiologo.it\/#\/schema\/person\/06e8bb8aa567c96de71714c12db8a26e\"},\"headline\":\"Occlusione percutanea dell\u2019auricola sinistra\",\"datePublished\":\"2024-06-23T19:33:18+00:00\",\"dateModified\":\"2026-03-09T09:14:40+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/grossicardiologo.it\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/\"},\"wordCount\":470,\"publisher\":{\"@id\":\"https:\/\/grossicardiologo.it\/#organization\"},\"image\":{\"@id\":\"https:\/\/grossicardiologo.it\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/2024\/06\/title-trattamenti-fibrillazione-atriale.png\",\"articleSection\":[\"Fibrillazione atriale\",\"Trattamenti\"],\"inLanguage\":\"en-GB\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/grossicardiologo.it\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/\",\"url\":\"https:\/\/grossicardiologo.it\/trattamenti-occlusione-percutanea-dell-auricola-sinistra\/\",\"name\":\"Occlusione percutanea dell\u2019auricola sinistra - 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